Inappropriate treatments in temporomandibular joint chronic recurrent dislocation: a literature review presenting three particular cases.

Chronic recurrent dislocation (CRD) is characterized by a condyle that slides over the articular eminence, catches briefly beyond the eminence, and than returns to the fossa. A variety of techniques have been proposed for the treatment of CRD involving tightening of the capsule with sclerosing agents, capsular plication, open condylotomy, eminectomy, and eminoplasty. In eminoplasty, to produce a barrier and eventually to incarcerate the condyle, zygomatic down-fracture, and autografts were used. Studies incorporating the use of screws and wires in the treatment of CRD have never been published. In this article, complications in three patients with CRD who were previously treated by screw eminoplasty and their treatment are presented. Three of the patients were referred to the author's clinic with reports of spontaneous and severe pain around the TMJ area. All of the patients reported in the article were treated previously by other surgeons by fixing screws on articular eminences in an attempt to limit the excursion of the condyle. Placement of materials such as screws with the purpose of creating a barrier, erosion of the articular eminence, and the anterior wall of the condyle are the major problems for this type of surgical option. The other option, as it is applied in treatment of the three cases presented, is to remove the barrier to enable spontaneous reduction, a process that is accomplished best by eminectomy.